Plaistow Jamia Islamia Madrasah Registration

Please fill the details student(s) to our waiting list. For more information, please contact us about this form.

* denotes required field

*Your name: (Parent/Guardian)

*Surname:

*Relation to student: Autofill: Father Mother Brother Sister

Type:

*Your email:

*Confirm email:

Parent Portal Password:

Confirm password:

If you already have an account and a password, you can skip this and leave it blank. Otherwise you should set your password now to login to the parent portal now.

Telephone:

*Mobile:

*Address: *Postcode:

Students

Student #1:

Surname:

D.O.B:

Gender:

Email:

Enroll:

Add medical info/notes

Contacts

You are the primary contact. You can add more contacts below.

Additional Contact #1

Contact Name:

Email:

Tel.:

Parent Portal Password:

Confirm:

Mobile:

Alt. Mob.:

Relation:

Type:

Primary Contact? This means the contact will receive emails related to the student. The contact will also see the student on the parent portal to view progress and other information. If you select no here, this contact will not see the student on the parent portal.

I consent that IBEUK can process this form and submit directly to Plaistow Jamia Islamia Madrasah. Your data will not be stored nor used by us.

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